Job Description

Job Summary

LetsLink is assisting a Private Hospital based in Centurion to employ a Billings Manager.

The incumbent will be responsible for the financial risk management of the hospital, by ensuring accurate and timeous billing of all patient accounts. The incumbent will do so by managing the Case Managers, File Assessors and the Confirmations Staff. The Billings Manager will also be responsible for ensuring effective patient liaison and dispute resolution.

Key accountabilities and responsibilities:

• Ensure effective patient liaison and dispute resolution
• Ensuring daily, weekly and monthly tasks as per Billing Manager level of task document
• Monitoring and maintenance of the DNYB and delayed weighting
• Monitoring and maintenance of PIP cases
• Monitoring and maintenance of high cost medication as per policy
• Monitoring and maintenance of claim rejections
• Maintain set targets as indicated on the BSC
• Monitoring and reporting on MHC variance
• Monitoring of ADCLIN system to ensure clinical appropriateness
• Ensure accuracy of ICD 10 AND CPT 4 coding
• Analysis of billing errors with appropriate action plans
• Management of ARS and other contracts and associated reporting
• Ensuring SOP's are up to date
• Effective management of cancelled cases
• Manage results on all audits
• Implement changes effectively
• Motivation of system enhancements and adaptations
• Manage credit control queries as per communication policy
• Ensure effective communication and follow through with medical aids
• Manage associated administrative tasks
• Assist with any other duties assigned by the Pharmacy Manager from time to time
• Assume responsibility for own personal and professional development
• Keep up to date with the hospitals evolving policies and procedures

Skills Required:

• Grade 12 or Equivalent NQF Level 4 qualifications
• Qualified Registered Nurse registered with SANC
• 3-5 years experience in a similar role
• Advanced computer literacy
• Sound knowledge of Private Hospital Pharmacy business operations
• Sound knowledge of medical/healthcare billings and tariff guidelines
• Application of clinical knowledge in the risk management of patients

Interested candidates who meet the above criteria are requested to e-mail a detailed CV to or apply directly through this platform. To learn more, please contact Gary on +27(0)110261907

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LetsLink (Pty) Ltd Recruitment & HR Specialists

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